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Survey of Emotional Distress

More than six percent of New Yorkers report suffering from "severe emotional distress," with Hispanics and the poor among the most likely to suffer such distress, according to a citywide survey released on April 30.

The city's Department of Health and Mental Hygiene surveyed 10,000 residents from 33 New York City communities in 2002. This Community Health Survey asked New Yorkers about the extent to which they had recently experienced conditions such as feelings of sadness and anxiety. Those who reported high levels of these feelings were classified as experiencing significant emotional distress: 6.4 percent of New Yorkers overall reported such distress.

According to Lloyd I. Sederer, M.D., Executive Deputy Commissioner of the Department's Division of Mental Hygiene, this is the first time the survey has been done, so it is not clear if the reported rates of severe distress have increased (for example, in response to the economic doldrums or threats of terrorism), decreased, or stayed the same over time. Sederer said the agency plans to repeat the survey in June in order to see if there have been any changes.

Sederer said the New York survey was unusual in its "snapshot" approach, asking how respondents had been feeling over the past 30 days. "That does make it hard to say how the rates would compare to the rest of the country," he said. A large national study done by the U.S. government in 1991, the National Comorbidity Survey, asked about feelings of depression and anxiety in the past year and over the respondents' lifetimes; it found that 10 percent of Americans had suffered from major depression and 17 percent from an anxiety disorder in the past year, and 17 percent from depression and 25 percent from an anxiety disorder over the course of their life to date.

One finding of the survey was a strong correlation between poor emotional health and poor physical health. Those who said they suffered significant emotional distress also reported being in poor physical health three times more often than New Yorkers who said they were not significantly distressed. Among those with significant distress, 54 percent said they were also in poor or merely fair physical health, versus 17 percent of those who felt better emotionally. Those who reported significant emotional distress generally had higher rates of chronic health conditions such as high cholesterol, high blood pressure, obesity, asthma, and diabetes.

Sederer acknowledged that it is not always clear whether emotional distress was leading to poor health or vice-versa, but he did note that those who reported more emotional distress tended to follow less healthy lifestyles, including less exercise, more binge drinking, greater likelihood of tobacco use, and poor diet. "If you're depressed or anxious, the likelihood is that you'll be at a much greater risk for so-called habit-related disorders -- those that result from drinking too much, smoking, and not taking care of yourself," he said. "But poor physical health can also definitely lead to emotional distress. In the elderly, for example, those who have chronic physical illnesses have much higher rates of depression than those who are physically healthy. It's important to be aware of that in order to screen for depression those who are at the higher risk."

Other survey findings included:

" Hispanics reported nearly twice the rate of severe distress as other New Yorkers (11.9 percent, versus 4 percent for Asians, 4.6 percent for blacks, and 4.9 percent for non-Hispanic whites). Sederer said that the reasons for this were not clear. "Is it a cultural issue, a greater willingness to talk about the problem, a problem with access to or seeking of care? The reasons haven't yet been well studied," he said.

" Neighborhoods with the lowest incomes tended to report the highest rates of significant emotional distress.

" Only 36 percent of New Yorkers who reported significant emotional distress were employed, compared with 60 percent of other New Yorkers.

" 55 percent of New Yorkers who reported significant emotional distress had annual household incomes of less than $25,000.

" Significant emotional distress was more frequently reported among people 45 and older.

" Significant emotional distress was more frequently reported among those who are divorced, separated, or widowed (9.6 percent) than those who are married or partnered (5.5 percent) or never married (6.6 percent).

"As with all of these studies, these are correlations, not analyses of which causes which," Sederer said. "But with the next survey, in June, we hope to refine the questions to tease out some of those issues."

The report noted that effective treatments exist for emotional problems, and it recommended that New Yorkers experiencing persistent symptoms of emotional distress seek help from their physician or a mental health counselor. 1-800-LIFENET, the city's free information and referral hotline for mental health and alcohol/substance abuse services, is available 24 hours a day, seven days a week. LIFENET can be reached at the following numbers:

The study also recommended some simple steps for better mental health that New Yorkers could take on their own: exercise regularly, eat a healthy diet, and refrain from abusing alcohol or drugs or smoking.

Meanwhile, the state legislature continues to battle to pass a state budget that would restore huge sums of money that Governor Pataki has proposed cutting from health care, including mental health care. The legislature passed an appropriation bill for health and mental hygiene that would restore $1.1 billion of $1.25 billion Pataki had proposed cutting, The New York Times reported on May 2. The Times quoted Richard N. Gottfried, a Democratic assemblyman from Manhattan and the chairman of the Health Committee, as saying that several hundred million dollars in federal Medicaid money would also return to New York under the legislative proposal.

Sue Wilson is a journalist who writes frequently on health and science topics for such outlets as the New York Times, WNET, and UNICEF.

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